Tonsil-snare



PATENT OFFICE.

CHARLES R. STOBZ, O15 BROOKLYN, NEW YORK.

, rt i v TONSIL-SNARE.

Specification of Letters Patent.

Patented Feb. 1, 1921.

Application filed October 17, 1919. Serial No. 331,307.

To all whom it may concern:

Be it ltnown that I, (hrannns It. Show, a citizen of the United States, and a resident of the city of New York, borough of Brooklyn. in the county of Kings and State of llew lorln have invented a new and Improved Tonsil-Snare, of which the following is a description.

lily invention relates to snares used by surgeons in removing the tonsils. The tonsil snare includes a rigid loop at the front of the instrument and -a wire loop or snare proper adapted to be disposed in the fixed loop to be placed adjacent to the tonsil, and forceps are employed to grasp the tonsil and draw it into the wire loop. The shank of the wire loop is listed to sliding element movable rearwurdly on the instrument by the surgeon with the linger of one hand while the other hand holds the forceps grasping the tonsil, the rearward movement of said sliding clement serving to initially constrict the wire loop in a. manner to tightly grip the tonsil which the wire loop is further tightened by the action of a screw rod to which the slide is clutched; whereby the screw rod serves to actuate the slide thus constricting the wire loop until the tonsil is severed thereby. In the usual instrument employed for the indicated operation, the clutch carried by the sliding element for en gaging the screw rod normally is held out of clutching position under the resiliency of the clutch which tends to spring away from the screw rod and in manipulating the instrument to initially constrict the wire loop by moving the sliding element and clutch rearwardly relatively to the screw rod, a rearward pull is exerted by the surgeon with his linger on a ring rigid with the slide at one side. In thus exerting a rearward pull on the slide to initially constrict the loop and grip the tonsil care must betaken by the surgeon lest heat the same time should exert pressure on the trigger provided for throwing the clutch into engagement with the screw rod, since the clutch is to be engaged by the screw rod only after the initial movement of the slide and the gripping of the tonsil by the snare said trigger being arranged at the opposite side of said sliding element from the ring. After the tonsil has been tightly gripped by the loop, the trigger is deliberately pressed to throw the clutch into engagement with the screw rod, and the pressure on the tri er.

grasp of the forceps on the tonsil is released, so that both hands may now manipulate the instrument for the final constriction of the loop, the one hand holding the instrument firmly, while with the other the screw rod is turned by means of a ring or loop on its rear end, and through engagement of the clutch with said screw rod the slide is gradually forced rearwardly until the loop severe the tonsil. It is a drawback to the surgeon that he is required to exert special care in the manipulation of the slide and trigger, and the prime object of my invention is to eliminate this objectionable feature from the instrument and to provide that the grasping of the slide by the surgeon and the rearward pull or pressure thereon will positively maintain the clutch out of clutching position to permit the free movement of the slide, as well as to arrange for the automatic throwing in of the clutch, the instant the surgeon relieves Therefore, my invention resides primarily in the provision of means for causing the clutch and trigger to be maintained in the release position so long as the surgeon exerts a rearward pull on the sliding element and to cause the clutch to be automaticallythrown into engagement with the screw rod the instant rearward pressure on the sliding element (and trigger) is re lieved by the surgeon.

A serious defect also in the ordinary instrument and one frequently causing serious annoyance to the surgeon is if the teeth of the clutch when springing to the clutch ng position should not properly register with the spiral groove of the screw rod, the teeth instead striking the thread or spiral rib of the screw rod, the surgeon is required in order to complete the operation to vibrate the trigger until the clutch teeth come opposite the spiral groove of the screw rod to permit the clutching engagement and insure the movement of the slide by the turning of the screw rod to finally constrict the loop and sever the tonsil.

An object of my invention is to automatically insurethe clutching action without the surgeon manipulating the trigger for thepurpose and therefore my invention further resides in providing a clutch normally and automatically tending to move to clutching position so that should the teeth of the clutch not register with the spiral groove of the screw rod, the slightest movement of the invention -permit of said shank being very conveniently detachedand replaced when desired. I

More specifically, I have in view to provide an embodiment of the invention reflecting'important considerations with respect to simplicity and durability of the assemblage as well as the convenience of disassembling the parts when required.

The novel features in which my invention resides are further set forth hereinafter in connection with a description of the distinctive structural elements characterizing the invention as carried out in practice in its preferred form, said features and element being defined in the appended claims.

Reference is to be had to the accompany ing drawings forming a part of this specification, it being understood that the drawings are merely illustrative of one example of-the invention.

Figure 1 is a plan view of a tonsil snare embodying my invention;

Fig. 2 is a side view thereof;

Fig. 3 is a fragmentary view inlongitudinal section given to show the lutch de vice and its control as well as other details to be hereinafter referred to, the clutch being the snare being in the forward position;

Fig.4 is a view similar to Fig. 3 but showing the sliding; element moved rearwardly asin the initial constriction of the snare loop. the clutch being shown in the rele se position;

Fig. 5 is a cross section on the line 5--5, Fig. 3; V

Fig. 6 is a cross section on the line 6-6, Fin. 3.

Tonsil snares to which the invention relates comprise generally a tubular shank 10 having at the front end a rigid loop 11 presenting an internal groove 12 to accommodate the wire loop 13 of the snare proper. The rear end of the tubular shank 10 is detachably secured in the present example, said end being received in a tubular socket 14 to be hereinafter referred to. Said shank 10 isrigid with a tubular stem 15 in which a screw rod 16 is disposed. said screw rod usually being secured to the tubular stem 15 by a swivel capl'? on the rear end of said stem. the redued portion of the screw rod extending through said cap and being provided at its rear end with a ring 18 or the like for turning the rod. A slide 19 is adapted to be moved longitiulinally on the tubular stem 15. The twisted wire shank it)" of the wire loop 13 terminates in a rigid cylindrical rear end or pin 13'' which is received in a longitudinal pin hole 15) in the slide 19 and made fast by a lateral set screw 13 or the like. ill the above parts except the details of the socket ll are common to tonsil snares as usually made, and moreover, a clutch is provided on the slide 19 to engage or disengage the rod l6. With the clutch disengaged the slide 19 is usually slid rearwardly by a rearward pull or pressure of the ring" 20, thereby drawing the shank 13" of loop 13 rearwardly in the tube 10 and thereby constricting said loop 13, after which the clutch is engaged with the rod and the latter turned to further move the slide 19 rearwardly. A tri er is employed to control the clutch in the usual snare the trigger being disposed at the opposite side of the slide from the ring 20.

In a'iicordance with my invention the trigger, 21, is pivoted to the slide 19 adjacent to the ring 20 and extends to the opposite side. In the present example use made of a transverse pivot pin 22 extending through fork arms 2b on trigger 21.; and

the slide 19 and through a boss 52-3 on the ring 20, said boss being let into the slide 19 and having a bore therethrough to rcg-- ister with the pin hole 19". Thus, the pivot pin 22 secures both the trigger Jr and the ring 20 in position on the slide. I employ a clutch 23 in the slide 1%) and ranging lengthwi e of the rod 16. said clutch being accommodated in the longitudinal slot 15 of tubular stem 15, said clutch 23 being pivoted between its ends and near one end by a transverse pin or the like and at the back the clutch is formed with a lougiludb nal recess presenting at the ends thereof front and rear shoulders 95, 26 adapted to be engaged by a controlling slide 2? having more or less the character of a vain. The slide 27 is actuated by the trigger 21 for throwing the clutch, said slide presenting a transverse opening 28 receiving; a tongue 29 on the trigger 21. so that the l)llf1' .l'0l acts to throw the clutch in both directions. The trigger 911 is spring-pressed, the spring means in the illustrated example consisting of a resilient wire return bent one end being made fast to the slide 19 as by a set screw 31, the other a longer arm of the spring bearing against the back of the triggel 21 between the same and a stop pin 3'2 on the slide. Two of said springs 30 may be advantageously employed in practice. disposed at the opposite sides of the slide 19 to bear against the trigger adjacent to the respective arms 21 thereof. The springs. it will be observed, normally tend to main- 1,see,971

tain the trigger 21 in theforward position. In the forward movement of the slide 27 by the trigger, the curved or earn-shaped :l'front end 27 of said slide engages the shoulder and earns oh the same to a position on its pivot and throwing the clutch teeth out of engagement with the screw rod.

l l ith the described arrangement, when the tonsil has been positioned by the forceps in. the loop 13, the surgeon is free to grasp both the ring 20 and the trigger 521, the front portion of the stem 15 extending between the second and third lingers of the hand. The grasping oil the trigger 21 throws it to the rearward position carrying with it the slide 537 and thereby releasing the clutch 23, so that the surgeon may exert a rearward pull on the slide, thereby drawing the wire shank I ll rearwardly and constricting the wire loo'o13 about the tonsil until the tonsil is tightly gripped whereupon. the pressure on the trigger is relieved. so that the spring means may throw the triggerforwardly and throw the teeth of the clutch 23 into engagement with the screw rod 16. The tonsil l. .ving been released by the forceps, one hand grasps the stem 15 or shank 10 or both, and the screw rod 16 is turned by the rod 18, thereby further carrying the slide 19 rearwardly and gradually increasing the c0nstriction oi the loop 13 until the tonsil is severed. It will be clear that the surgeon is relieved of all concern as to the operation of the clutch, since its release is insured with the simultaneous grasping oi the trigger 21 and ring 20 and instead of being required toeirerciee caution as to exerting pressure on the trigger, the natural act of pressing the trigger backwardly not only releases the clutch but constitutes the trigger part of the means for pulling the slide 19 and the snare loop rearwardly. Moreover, the automatic throwing oi the clutch into engagement with the screw rod 16 can be relied upon since even if the clutch teeth should strike the spiral rib of the screw rodinstead of the groove thereof, the first partial turn of the screw rod by the ring 18 brings the clutch teeth into register with the groove of the screw rod.

it highly important advantage of the de scribed construction and operation is that the surgeon is not required to maintain pres sure on the trigger in order to insure the engagement of the clutch with the rod 16 but isiree to disregard the trigger in the throw- 111g in of the clutch so that the one hand is tree to lirrnly grasp the instrument; while the screw rod 13 is turned with the other hand.

For securing the rear end 01 the tubular shank 10 to the forward end of the tubular stem. 15 in accordance with my invention, a plug 38 is rigidly fitted in the forward end of said tube 15 and has a threaded bore 33 adapted to receive a screw 341:. Said plug 33 is counter-bored at its rear end as at 33" and the inner end 34 of screw 34 is upset or otherwise enlarged so that the szrew may have a longitudinal play in the plug limited by said end e The forward end 3 1" of screw 34 enlarged and advantageously milled for turning it and at the base of said head is aconical zone Ell. The screw 3:: passes through a washer35 having an eye sutlicieutly large to accommodate the conical tone 34: A lateral notch 15 is formed in the shank 10 at the socket 14 adapted, when said shank is in position in said socket, to register with a slot 15 in the tube 15.; Therefore, when the screw is turned outwardly so that the zone Bel is moved out oi. the washer said washer by reason of the reduced diameter of the threaded shanlr oil the screw has clearance to move laterally in its own plane out of the notch 15", thus releasing the shank 10 and permitting the latter to be pulled out of the socket 14: as for example when substituting smaller or larger loops 12, 13 on the instrument. When the shank 10 is replaced in the socket 14, a for ward turning of the screw 3% into the plug will engage the zone 34 with the washer 35, thereby forcing the said washer laterally into the notch 15.

I would state in conclusion that while the illustrated example constitutes a practical embodiment of my invention, I do not limit myself strictly to the mechanical details herein illustrated, since manifestly the same can be considerably varied without depar" ture from the spirit of the invention as defined in the appended claims. 1

Having thus described my invention, I claim:

1. In a tonsil snare having a snare-carrying slide and an actuating rod therefor: a clutch carried by the slide adapted to en gage said rod. a slid-able clutch actuating element movable relatively to the clutch and relatively to said slide in opposite directions to cause engagement or disengagement Oil the clutch and rod, and a trigger roclrable relatively to said actuating ele ment and operatively engaging the latter.

2. In a tonsil snare having a snare-carrying slide and an actuating rod therefor: a clutch carried by the slide adapted to en gage said rod, a slidable clutch actuating ele" ment movable relatively to the clutch and relatively to said slide in opposite directlons to cause engagement or disengagement Elli ill)

of the clutch and rod; together with automatic means tending to move said clutch-actuating element in one direction to effect the clutching action, and a manually operable trigger to move said clutch actuating element in the reverse direction to move the clutch to release position.

3. In a tonsil snare having a snare-carrying slide and an actuating screw rod therefor: a clutch carried by the slide andadapted to engage said rod, spring-pressed means tending to normally throw the clutch to clutching position, and a trigger movable relatively to the slide to throw the clutch to release position, said trigger in the release position of the clutch engaging the slide and constituting a handle member for actuating the slide independently of the screw rod.

4. In a tonsil snare having a snare-carrying slide and an actuating screw rod therefor: a clutch carried by the slide and adapted to engage said rod, a clutch actuating element slidable adjacent to the clutch and movable in opposite directions to cause engagem nt or disengagement or" the clutch and rod, a trigger engaging said clutch actuating element and movable relatively to the slide to efiect disengagement of the clutch and rod, and spring means acting on said trigger and tending to throw the same to a position to move said clutch actuating element in a direction to cause engagement of the clutch and rod, said trigger when moved to a position with the clutch disengaged, engaging the slide and constituting a handle member for actuating the slide independently of the screw r0 5. In a tonsil snare having a snare-carrying slide and an actuating screw rod therefor: a clutch carried by'the slide and adapt- 7 ed to engage said rod, a clutch actuating element slidable adjacent to the clutch and movable in opposite directions to cause engagement or. disengagement or" the clutch and rod, said clutch presenting shoulders respectively facing rearwardly and for- Wardly, and said slidable element presenting forwardly. disposed and rearwardly disposed surfaces for engagement respectively with said shoulders, a trigger engaging said clutch-actuating element to cause movement of the same in opposite directions by reverse movements of the trigger. and spring means tending to throw the trigger in a direction to effect engagement of the clutch and rod, said trigger l eing manually movable in the opposite direction to release said clutch, the trigger constituting means to actuate the slide in the release position of the clutch and without affecting the latter.

6. In a tonsil snare employing a stem, and a member adapted to receive a snare element; means to detachably secure said member to the stem, said means including a socket presenting a lateral slot, a locking device mounted on the stem adjacent to the slot and movable to a position protruding into said socket through said slot or to a position withdrawn from said socket, and means movable axially on the stem and adapted to move said lo king device to the locking position and hold said device against release movement, said snarc-receiving element being adapted to be received in said socket and having a notch to receive said locking device.

In a tonsil snare employing a stem and a member adapted to receive a snare element: means to detachably secure said member to the stem, said means including a socket presenting a lateral slot, a *asher on the stem and movable laterally in its own plane to protrude into said socket through said slot or to a position withdrawn from said socket, a screw movable axially on the stem and extending through said washer. said screw presenting an enlarged conical zone adjacent to the washer, the screw being movable in one direction to engage the conical zone thereof with the washer for moving the latter to the locking position and holding it in said position, said screw being movable in the opposite direction to withdraw the conical zone from the washer and permit the latter to be moved in its own plane to release position out of said socket, said snare-reeiving element being adapted to be received in said socket and having a notch to receive said locking device.

CHARLES R. STORZ. 

